Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov 1;210 Suppl 1(Suppl 1):S162-72.
doi: 10.1093/infdis/jiu022.

Polio eradication initiative in Afghanistan, 1997-2013

Diane M Simpson  1 , Nahad Sadr-Azodi  1 , Taufiq Mashal  2 , Wrishmeen Sabawoon  3 , Ajmal Pardis  4 , Arshad Quddus  5 , Carmen Garrigos  6 , Sherine Guirguis  7 , Syed Sohail Zahoor Zaidi  8 , Shahzad Shaukat  8 , Salmaan Sharif  8 , Humayan Asghar  9 , Stephen C Hadler  10
Affiliations

Polio eradication initiative in Afghanistan, 1997-2013

Diane M Simpson et al. J Infect Dis. .

Abstract

Background: This article reviews the epidemiology of polio, acute flaccid paralysis (AFP) surveillance, and the implementation of supplemental immunization activities (SIAs) in Afghanistan from 1997 thru 2013.

Methods: Published reports and unpublished national data on polio cases, AFP surveillance, and SIAs were analyzed. Recommendations from independent advisory groups and Afghan government informed the conclusions.

Results: From 1997 thru 2013, the annual number of confirmed polio cases fluctuated from a low of 4 in 2004 to a high of 80 in 2011. Wild poliovirus types 2 and 3 were last reported in 1997 and 2010, respectively. Circulating vaccine-derived poliovirus type 2 emerged in 2009. AFP surveillance quality in children aged <15 years improved over time, achieving rates>8 per 100,000 population. Since 2001, at least 6 SIAs have been conducted annually.

Conclusions: Afghanistan has made progress moving closer to eliminating polio. The program struggles to reach all children because of management and accountability problems in the field, inaccessible populations, and inadequate social mobilization. Consequently, too many children are missed during SIAs. Afghanistan adopted a national emergency action plan in 2012 to address these issues, but national elimination will require consistent and complete implementation of proven strategies.

Keywords: Afghanistan; disease eradication; epidemiology; polio; strategies.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Political map of Afghanistan showing regions and districts.
Figure 2.
Figure 2.
Genetic profile of wild poliovirus cases in Afghanistan and Pakistan, 2012 (A) and 2013 (B). Abbreviation: PV1, poliovirus type 1.
Figure 3.
Figure 3.
Wild poliovirus polio cases types 1 and 3 and Supplementary Immunization Activities, Afghanistan, 2010–2013.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Progress toward poliomyelitis eradication—worldwide, January 2011–March 2012. MMWR Morb Mortal Wkly Rep 2012; 61:353–7.
    1. Ministry of Public Health, Islamic Republic of Afghanistan. Annual report 2012, Polio Eradication Initiative, Afghanistan. http://www.polioeradication.org/Portals/0/Document/InfectedCountries/Afg.... Accessed 23 June 2013.
    1. World Health Organization. Regional Office for the Eastern Mediterranean Region. Polio Eradication Initiative http://www.emro.who.int/polio/about/. Accessed 23 June 2013.
    1. Centers for Disease Control and Prevention. Progress toward poliomyelitis eradication—Afghanistan, 1994–1999. MMWR Morb Mortal Wkly Rep 1999; 48:825–9. - PubMed
    1. Ministry of Public Health, Islamic Republic of Afghanistan. Afghanistan emergency action plan for polio eradication 2012–2013. http://www.polioeradication.org/Portals/0/Document/Aboutus/Governance/IM.... Accessed 23 June 2013.

Publication types

Substances